Purpose

• Urine specimens are collected for urine tests.
• A midstream specimen is also called a clean-voided specimen or clean-catch specimen. The perineal area is cleaned before collecting the specimen. This reduces the number of microbes in the urethral area. The person starts to void into a device. Then the person stops the urine stream, and a sterile specimen container is positioned. The person voids into the container until the specimen is obtained.
• Stopping the urine stream is hard for many people. You may need to position and hold the specimen container in place after the person starts to void.
• Follow these rules for collecting urine specimens:
  • Follow the rules of medical asepsis.
  • Use a clean container for each specimen. Use the correct container.
  • Do not touch the inside of the container or lid.
  • Label the container in the person’s presence. Provide clear, accurate information.
  • Collect the specimen at the correct time.
  • Ask a female if she is menstruating. Tell the nurse. Menstruation may cause blood to be in the urine specimen.
  • Instruct the person. The specimen must not contain stools or toilet tissue.
  • Place the specimen container in a labeled BIOHAZARD plastic bag. Do not let the container touch the outside of the bag. Seal the bag.
  • Take the specimen and requisition slip to the laboratory or storage area.

Equipment

Roll cursor over items to see labels. For the purposes of clearly depicting the equipment, a barrier is not shown in this photo. When providing care, a barrier should always be placed on the surface before placing the equipment.

Wash basin

Wash basin

Paper towels

Laboratory requisition slip

Bath blanket

Towel

Washcloth

Disposable gloves

Specimen bag

Specimen pan

Cleaning agent for perineal care

Graduate to measure output

Midstream specimen kit—specimen container, label, towelettes, sterile gloves

Sterile gloves, if not part of the kit

Delegation

• Follow delegation guidelines. Before collecting a urine specimen, obtain this information from the nurse and care plan:
  • Voiding device used—bedpan, urinal, commode, or toilet with specimen pan
  • The type of specimen needed
  • What time to collect the specimen
  • What special measures are needed
  • If you need to test the specimen
  • If measuring intake and output (I&O) is ordered
  • What observations to report and record
  • When to report observations
  • What patient or resident concerns to report at once

Preparation

• Observe quality-of-life measures.
• Review the information under Delegation and Safety and Comfort.
• Practice hand hygiene.
• Before going to the person’s room, collect the items on the equipment list, from the laboratory requisition slip through the BIOHAZARD label.
• Arrange your work area.
• Identify the person. Check the ID bracelet against the requisition slip. Compare all information. Also call the person by name.
• Put on disposable gloves.
• Collect the remaining items on the equipment list.
• Provide for privacy.

Safety

• Blood, body fluids, secretions, and excretions may contain blood and microbes. This includes urine specimens. Follow Standard Precautions and the Bloodborne Pathogen Standard when collecting, testing, and handling specimens.

Comfort

• Urine specimens may embarrass some people. They do not like clear specimen containers that show urine. It may be helpful to place the specimen container in a paper bag. Or provide a paper towel or washcloth to wrap around the container.

Follow-up Care

• Provide for comfort.
• Place the call light within reach.
• Raise or lower the bed rails. Follow the care plan.
• Unscreen the person.
• Complete a safety check of the room.
• Practice hand hygiene.
• Take the specimen and requisition slip to the laboratory or storage area. Wear gloves.
• Remove and discard the gloves. Practice hand hygiene.

Reporting/Recording

• Report and record your observations, including:
  • Problems obtaining the specimen
  • Color, clarity, and odor of urine
  • Blood in the urine
  • Particles in the urine
  • Complaints of pain, burning, urgency, difficulty voiding, or other problems
  • The time the specimen was collected